Abstract

BackgroundInternalizing mental illnesses associated with psychological distress are often underdetected. Text-based detection using natural language processing (NLP) methods is increasingly being used to complement conventional detection efforts. However, these approaches often rely on self-disclosure through autobiographical narratives that may not always be possible, especially in the context of the collectivistic Japanese culture.ObjectiveWe propose the use of narrative writing as an alternative resource for mental illness detection in youth. Accordingly, in this study, we investigated the textual characteristics of narratives written by youth with psychological distress; our research focuses on the detection of psychopathological tendencies in written imaginative narratives.MethodsUsing NLP tools such as stylometric measures and lexicon-based sentiment analysis, we examined short narratives from 52 Japanese youth (mean age 19.8 years, SD 3.1) obtained through crowdsourcing. Participants wrote a short narrative introduction to an imagined story before completing a questionnaire to quantify their tendencies toward psychological distress. Based on this score, participants were categorized into higher distress and lower distress groups. The written narratives were then analyzed using NLP tools and examined for between-group differences. Although outside the scope of this study, we also carried out a supplementary analysis of narratives written by adults using the same procedure.ResultsYouth demonstrating higher tendencies toward psychological distress used significantly more positive (happiness-related) words, revealing differences in valence of the narrative content. No other significant differences were observed between the high and low distress groups.ConclusionsYouth with tendencies toward mental illness were found to write more positive stories that contained more happiness-related terms. These results may potentially have widespread implications on psychological distress screening on online platforms, particularly in cultures such as Japan that are not accustomed to self-disclosure. Although the mechanisms that we propose in explaining our results are speculative, we believe that this interpretation paves the way for future research in online surveillance and detection efforts.

Highlights

  • Adolescents often display premonitory symptoms of mental illnesses arising from psychological distress [1,2,3]

  • Youth with tendencies toward mental illness were found to write more positive stories that contained more happiness-related terms. These results may potentially have widespread implications on psychological distress screening on online platforms, in cultures such as Japan that are not accustomed to self-disclosure

  • We propose that psychological distress in the writer may be observable through their written narratives

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Summary

Introduction

Background Adolescents often display premonitory symptoms of mental illnesses arising from psychological distress (such as depression and anxiety-related disorders) [1,2,3]. Any delay between the onset of psychopathological symptoms to diagnosis and clinical treatment can result in a worsening of the condition, leading to complications for the individual’s mental health and with respect to their physical health and social relationships [4]. Youth tend to report more symptoms of internalizing mental illnesses https://formative.jmir.org/2021/8/e29500 XSLFO RenderX. Text-based detection using natural language processing (NLP) methods is increasingly being used to complement conventional detection efforts. These approaches often rely on self-disclosure through autobiographical narratives that may not always be possible, especially in the context of the collectivistic Japanese culture

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